This past weekend, we had "feels like" temperatures of 103 degrees. Rumor has it, temperatures were even warmer on Monday. It doesn't look like this is going to go away before the dog days of August.
I spent Sunday sitting outdoors at a local sporting event. A 21 year old young man who was a member of our party developed signs of heat exhaustion after 2 hours. He had headache, fatigue and muscle cramps. Even though I am much older, I didn't start feeling the effects of the heat until I had been out for 4-5 hours. I was tired, and starting to fall asleep in my chair. Okay, I was also starting to get irritable. However, I was drinking 12 oz of water (and other fluids) every hour, and I may be in better shape than the young man.
This weather can be particularly dangerous for athletes who are practicing outdoors. We need to keep this in mind as we send our youngsters off to sports camps. Heatstroke is dangerous and can kill. Heat exhaustion is the early stage of heatstroke. Risk factors for heatstroke are dehydration, fatigue, poor fitness and lack of acclimatization to the weather. Once the temperature is over 98 degrees (and humidity is over 55%), children should rest 5-10 minutes after every 25-30 minutes of activity. I strongly recommend encouraging them to drink water during these breaks.
Your children may not get heatstroke if they are swimming. However, they can still get dehydrated. This puts them at risk for developing heatstroke during later activities. It is easy to forget this risk, since they are wet and less hot while in the pool. They have less evaporative water loss through their skin, but their bodies still use more water than on a cool day. Also, they are exercising in that water, even when they are just playing. Have them stop hourly for something to drink.
Football seems to have the highest risk of heatstroke, with 27 deaths over the last 10 years. Much of that increase in risk is due to their need to wear protective equipment. If temperatures are over 98 degrees and the humidity is over 55%, these kids should be in only shorts and t-shirts with helmet and shoulder pads. As the humidity rises over 80%, they should remove all safety equipment to continue activity. This also means they have to alter their activity, as they are not wearing safety equipment. There are differing recommendations about when to stop activity, with some references saying you don't need to stop until humidity is 100%. I wouldn't wait that long.
If a child or teen is having headaches or muscle cramps, these could be signs of heatstroke. Move the individual to a cool place and give plenty of fluids. Water is best. Juice can also help, but avoid caffeinated beverages. This is one of the few times when I recommend a sports drink with electrolytes. (However, the majority of their fluid intake should be water). If their body temperature is 102 degrees or more, immerse them in cold water (and consider calling 911). A great way to do this is with a plastic wading pool, ice and lots of water. You want to immerse the person in cold water, except for their face. Nausea, vomiting and dizziness can also be signs of heatstroke. If the child is also dehydrated, they may have difficulty sweating. The skin will be red, hot and dry. If the person has rapid breathing, a rapid pulse, seems confused, disoriented or is hallucinating, call 911 while you are cooling them in the wading pool.
Let's keep our kids safe while they enjoy the activities they love. For additional information, contact your Personal Medicine provider.
Dr Nan N
House Call Pediatrician, Overland Park, KS
Fireside Pediatrics
State of the art care for your child in your home
http://FiresidePediatrics.com
www.PersonalMedicine.com
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